Orbitary sclerosant inflammation with extraorbital extension associated with cerebal infarction: case report

Abstract

Introduction: Idiopathic orbital inflammatory syndrome is a clinical entity characterized by a non-specific intraorbital inflammatory infiltrate, which may mimic a malignant tumor. Extraorbital extension is rare.
Case report: A 70-year-old white male patient with a personal history of hypertension and ischemic heart disease was evaluated three months before admission for unilateral ocular proptosis accompanied by headache, malaise, and anorexia. An initial head CT scan was performed, which revealed a hyperdense mass located in the orbital apex. The mass was diagnosed as orbital pseudotumor and dexamethasone treatment was prescribed for 2 months. Magnetic resonance imaging: A hyperintense image was defined in the left maxillary sinus region that exceeded the lower floor of the orbit and extended to the ocular cavity of the left eye with hypodensity throughout the cavity without defining the optic nerve. Histological study of the periorbital fatty tissue sample: sample consisting of connective tissue, adipose tissue, striated muscle, and nerves. It is concluded that, given the clinical elements found in the interrogation and physical examination, the normal complementary studies that rule out other pathologies, the diagnosis of: Orbital fatty inflammatory pseudotumor, cerebral microangiopathy of atherosclerotic etiology.
Conclusions: This patient is a rare case of orbital sclerosing inflammatory disease with extension to the maxillary sinus. It is essential to broaden the horizons of neurological pathology and expand diagnostic investigations in order to implement the most effective therapies to improve the patient's quality of life and avoid complications.